🇮🇹 Italy → 🇺🇸 United States

The case concerned a person held in custody in Italy pending extradition proceedings before the Court of Appeal of Bologna. The defence sought revocation or substitution of the custodial measure, arguing that the requested person’s health conditions were incompatible with prison detention. The Court of Appeal rejected the application, relying on the continuing risk of flight and on a prison medical report which considered detention compatible with the person’s health, without ordering an independent expert assessment. The Italian Supreme Court annulled that decision. It held that, where an application for revocation or replacement of custody is based on alleged incompatibility between the person’s health conditions and prison detention, the court must order medical assessments in expert form unless the alleged incompatibility is unsupported by adequate justification or the situation is clearly compatible with detention. That was not the case here. The prison medical report did not provide a stable and conclusive clinical picture, referred to the need for constant monitoring, and did not clarify whether the necessary diagnostic and therapeutic measures could be adequately and promptly provided within the prison system or in a prison medical facility. Only after such assessment could the court properly evaluate the continuing need for custody, the concreteness of the risk of flight, and the possible adequacy of less restrictive alternative measures. The order was therefore annulled with remand for a fresh assessment.

The Court of Appeal must refuse extradition “where reasons of health or age entail a risk of consequences of exceptional gravity for the requested person.” Such a ground for refusal may apply not only where adequate medical treatment cannot be ensured in the requesting State, but also where the extradition procedure itself is liable to prejudice the person’s health. In particular, such prejudice does not arise from any negative impact on the individual’s health, but only where extradition may result in consequences of exceptional gravity, namely serious and objectively verifiable pathological effects. Accordingly, the Court cannot confine its assessment to verifying whether the healthcare facilities in the requesting State are adequate to meet the person’s therapeutic needs, but must also take into account the concrete impact—and thus the potential adverse effects—of the surrender procedure on the requested person’s health. This includes, for example, the difficulties and possible complications arising from the transfer abroad or the need to avoid interruption of ongoing medical treatment.